19 Apr 2023

Taskforce to address health staff gaps failing to deliver, doctors say

5:47 am on 19 April 2023
Healthcare people

There were no reports or recommendations, and engagement had been minimal, one leading doctor said. Photo: 123rf

Senior and junior doctors say the government's national workforce taskforce set up months ago with fanfare has not delivered.

They say it is not even clear what is being done to avert the most immediate threat - another winter of crisis for GPs and hospitals.

The government last August laid out measures it said were just the start of a national workforce plan.

The 12-member taskforce followed with a pledge to focus on areas requiring "immediate attention" and on substantive improvements.

It has since set up six professional working groups and 20 profession steering groups.

But nine months on, as the taskforce chair steps down, Dr Deborah Powell of the junior doctors' union - the Resident Doctors' Association - has been left struggling to see what has been achieved.

She went to just two taskforce meetings.

"I can safely say it was tokenism. We just didn't get a chance," she said.

"The taskforce, as far as I could see, hand-selected a few individuals - not necessarily with any workforce experience and certainly not representative of the workforce - and went about its business, and, as far as we are aware, has produced very little."

Sarah Dalton, who heads the senior doctors' union - the Association of Salaried Medical Specialists (ASMS) - described a similar experience.

"We were part of one medical engagement group which met twice and achieved nothing," Dalton said.

"We sat around, we had a chat one day, we talked about what we thought were priorities.

"What could you expect to happen in two meetings to talk about the whole of the medical workforce?"

Sarah Dalton, Association of Salaried Medical Specialists executive director

Sarah Dalton Photo: LDR / Stuff / Kevin Stent

ASMS was calling for a workforce census and an analysis of unmet health needs - but the data was lacking, both Dalton and Powell said.

"Our huge disappointment and frustration is that no one has yet done the hard work to nail down... a health workforce census," Dalton said.

"Who are our people? Where are they? What do they do? What are the obvious gaps? What are the priority areas that we need to fill?

"As far as I can tell, none of this has happened."

The Resident Doctors' Association had also pushed for better data, one of two key things - along with more medical students - it wanted from the taskforce.

Powell, who also heads the APEX union of allied, scientific and technical employees in the health sector, said it had been "a failure".

"Let's be blunt here. To the best of my knowledge, it hasn't achieved anything."

There were no reports or recommendations, and engagement had been minimal, she said.

The doctors' unions together represented more than 6000 members.

Dalton said the first draft report from the workforce taskforce was due out any day.

'We haven't had any visibility of that," she said.

"Based on what I've seen and heard around the work of the taskforce, in some ways it seems to have been, I don't know, a process of 'magical thinking' about what the future might look like… with no real ties to our current state."

General Practice New Zealand chairperson, Dr Bryan Betty

Bryan Betty. Photo: Supplied

General Practice New Zealand chair Dr Bryan Betty said very senior health leaders were having input to the taskforce.

He hoped Te Whatu Ora would pick up on ideas such as giving young doctors more exposure to GP practices early on.

"Progress is slow at the moment as these plans get put in place," Betty said.

"But these take time to initiate - there [are] no quick fixes here, and that's one of the issues we're faced with."

Changes and restructuring were making it harder - "the churn within Te Whatu Ora", he called it.

In a statement, Te Whatu Ora said its workforce taskforce had a draft plan to tackle medical staffing shortages but it was still being reviewed by its members.

It said the taskforce had set up six groups to develop staffing pipelines, had helped with systems to bring in health workers from overseas and to get them out into rural areas.

It said it was working constructively with unions and key agencies.

Winter looming

The most immediate question is how hospitals will cope this winter. Both Powell and Dalton said it was looking as bad or worse as winter 2022.

Te Whatu Ora has set up a group to come up with ideas for rapid winter responses at the community primary health level. Betty was in the group, which he said was set up six weeks ago and had met three times.

"Certainly, the timeframe's been quite short in this instance."

It would be good in future to set up such a group straight after the preceding winter, he said.

Some ideas had been put through, such as to boost immunisations, "but we are still waiting for Te Whatu Ora to progress that work", he added.

Ideally, junior doctors who manned emergency departments, and hospitals, would be part of the winter brainstorming, Betty said.

But Powell had not even heard of the winter working group until RNZ told her about it.

"I have heard nothing of it," she said. "I'm sure I would have heard of it if it had people on it who were in the know."

The GPs' online newsletter said winter was one of three "system priorities" the Health Minister Ayesha Verrall laid out - the other two workforce and waiting lists/planned care.

But Dalton said senior doctors - the specialists who make up the top ranks of the hospital workforce - had yet to have a sit-down with decision-makers about it.

"We have several times spoken to Te Whatu Ora about the need to talk about winter rates, winter surge.

"We've told them we need to discuss it with them and they need to make a time, but they haven't yet got back to us on that. We will be following up with them at our meeting on Friday."

Te Whatu Ora and Verrall were approached for comment.

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